Integrating HIV testing with immigrant health and welfare programs in oakland, CA: Best practice in reaching an underground population

Issues Nearly 20% of all Latinos newly diagnosed with HIV infection in Oakland, California are concurrently diagnosed with AIDS. Structural barriers related to immigration status may be contributing factors. Our NIH-supported study of late stage HIV diagnosis further documents sex work activities among Latino low wage immigrant workers (LWIW), many of whom have low HIV knowledge and are not routinely testing. We integrated HIV testing into a multi-service center to assess the feasibility of improving uptake of HIV testing among LWIW, and barriers and facilitators of testing utilization with this hard- to -reach population

Description We partnered with La Clinica de la Raza to provide HIV testing and Street Level Health Project (SLHP) - which provides general health screenings, psychosocial and basic needs support to LWIWs. We integrated HIV testing into existing SLHP services to assess the feasibility of improving uptake of HIV testing. Testing was coupled with an optional interviewer administered survey to understand barriers and facilitators to HIV prevention services.

Lessons Learned LWIWs in Oakland have low knowledge of the importance of routine HIV testing. Most participants acknowledge the occurrence of sex work among fellow LWIWs. Preliminary data suggests that offering confidential HIV testing at a the multipurpose center nearly doubled the acceptance of HIV testing in this center. Providing testing at times that fit the workers' schedules may help facilitate uptake.

Recommendations Integrating HIV testing as part of overall multi-purpose programming for LWIW is feasible, with steps taken to ensure convenience and refining messages about regular testing